It is very common for business people and in-house lawyers to assume that their procedures for benefit determinations and benefit determinations on review have been vetted by counsel and are fully ERISA compliant.

Defending ERISA litigation is a reality that can be expensive and frustrating. To minimize potential headaches and costs, it is important not to inadvertently give your opponent any unnecessary advantages.

One potential pitfall involves ERISA's detailed requirements for the timing and content of benefit determination notifications and benefit determinations on review, as well as the requirements for appeals of adverse benefit determinations. Many of these requirements are found in the Department of Labor's (DOL) rules regulating disability claims procedures (29 C.F.R. § 2560.503-1).

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It is very common for business people and in-house lawyers to assume that their procedures for benefit determinations and benefit determinations on review have been vetted by counsel and are fully ERISA compliant. The same is true for the requirements applicable to appeals of adverse benefit determinations. It often comes as a surprise (and sometimes a source of embarrassment) when this is not the case.